The Use of Intracavernous Injection and Audiovisual Sexual Stimulation during Real-Time Pharmacopenile Doppler Ultrasonography in Vasculogenic Erectile Dysfunction

Abstract

Introduction: The objective of this study was to explore the role of intracavernous injection (ICI) and audiovisual sexual stimulation (AVSS) during real-time pharmacopenile Doppler ultrasonography (PDDU) in vasculogenic subtypes of erectile dysfunction. Materials and Methods: A total of 200 consecutive men with erectile dysfunction (ED) were enrolled. Each patient received 2 sessions of real-time PDDU. Session A was performed under ICI alone. Session B was performed under ICI plus AVSS. The interval between sessions was 7 days. Penile vascular parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index, were monitored 5, 10 and 20 min after the start of the test. Patients were asked to describe the level of sexual arousal generated by choosing one of the pre-set answers. Results: In veno-occlusive ED, during session A, EDV at 10 min was significantly greater than at 5 and 20 min (p < 0.05). During session B, there was a significant difference regarding PSV in arteriogenic ED (p < 0.05). Mixed vasculogenic ED showed significant differences in PSV levels during session B, and EDV at 5 min was greater than at 10 and 20 min (p < 0.05). PDDU under ICI alone diagnosed 34 (17%), 35 (17.5%), 31 (15.5%) and 100 (50%) cases of arteriogenic, veno-occlusive, mixed vasculogenic and nonvasculogenic ED, respectively. The combination of ICI plus AVSS diagnosed 27 (13.5%), 44 (22%), 7 (3.5%) and 122 (60.7%) cases, respectively. Conclusions: Adding AVSS during PDDU improves the recording of physiologic erectile response and may help the physician to accurately evaluate the cause of ED.

Is milder psychological stress responsible for more severe erectile dysfunction?

“…In the past, ED was considered to be a purely or primarily psy- Papagiannopoulos, Khare, & Nehra, 2015). With more research and more advanced diagnostic approaches (Tang, Tang, Dai, Lu, & Jiang, 2013;Tang et al, 2009), the current evidence suggests that potential organic risk factors or aetiologies were determined in more than 80% of cases (Yafi et al, 2016). Erectile dysfunction is most often a complex disorder associated with multivariable factors that can be classified as psychogenic, organic, or mixed psychogenic and organic.…”

Organic Causes of Erectile Dysfunction in Men Under 40

“…The large percentage of vascular anomalies should encourage physicians to consider a workup with NPT and penile Doppler studies if no other etiologies are clearly identified. The combination of intracavernous injection and audiovisual sexual stimulation may improve the recording of physiologic erectile response during the Doppler study [41]. …”

Do Urologists Really Recognize the Association Between Erectile Dysfunction and Cardiovascular Disease?

“…Arterial ED, which could be detected more accurately by real-time pharmacopeias Doppler ultrasonography, has been proved to be an influential factor in cardiovascular events. 18,19 Nonetheless, the universal understanding of ED still remains a problem: almost half of the urologists believed that ED was a feature of the aging rather than a disorder. This might be due to a higher risk of ED in older people.…”